The Sunday News
Robin Muchetu, Senior Reporter
IN a major milestone that will curb pill fatigue and reduce default cases, Zimbabwe will among other countries introduce a new HIV preventive drug that will be taken only once a month.
In the country, drugs to prevent HIV infection, and drugs for HIV-positive people on anti-retroviral therapy, are taken daily. Officials said the Antiretroviral, Islatravir, will be administered to HIV-negative people as a way of preventing infection (Pre-Exposure Prophylaxis) and will only be taken once every month compared to Truvada which is already in use but is taken daily.
Principal Investigator at the University of Zimbabwe’s Clinical Trials Research Centre Dr Nyaradzo Mgodi said the new drug was going to be a game-changer in the area around HIV prevention as pill fatigue was taking a toll on the population.
“We have started work on a new drug called Islatravir that we are investigating to see if it can prevent HIV infection if taken once a month only. One will not have to take one pill every day, rather, we are doing research to see its effectiveness if taken once a month.
“Islatravir is a form of an Antiretroviral Drug, these drugs, however, have various classes as some prevent infection from HIV, some attack the virus as soon as the virus enters the cells and so on. Islatravir is effective in that it prevents HIV infection in two ways as it enters the body. As scientists we are looking into that this new drug be taken once a month as a form of HIV prevention while comparing it with Truvada which is taken daily,” she said in an interview.
Dr Mgodi said there was a challenge of pill fatigue and defaulting as drugs were taken daily.
“We realised that people experience pill fatigue by taking one pill every day of their lives so we want to see how Islatravir will fare since it is taken once a month,”’ she said.
Dr Mgodi, who has vast experience in clinical trials on HIV prevention in women said there was a need to give women the choice of protecting themselves from HIV infection. According to Avert Global HIV statistics for 2018, young women are at risk with 6 200 new infections each week among young people aged 15-24 occurring in this group. In Sub-Saharan Africa four in five new infections are among girls aged between 15 and 19 and young women whose ages range from 15 to 24 are twice as likely to be living with HIV as men.
“For us to protect women from the scourge of HIV and Aids we have to give each and every woman a choice she can use to protect herself. We already have the Dapivirine ring which can be inserted into the reproductive organ of a woman and it releases the ARVs slowly over a period of 28-35 days as a way of preventing HIV infection. There is also an injectable dolutegravir, another HIV prevention drug and the Truvada drug, which is Pre-Exposure Prophylaxis taken daily which aids in protecting one from HIV infection,” said Dr Mgodi.
Dr Mgodi said the new trials were motivated by people who wanted a different option but were still taking ARVs orally.
“In our research we discovered that there was a group of people who did not want an injection, the vaginal ring or implants but preferred to take drugs orally but they also did not want to take the drugs every day. Taking any drugs orally everyday is a challenge. We know that drugs like Truvada for HIV prevention work very well but what makes it fail to work properly is as a result of people forgetting to take their drugs every day,” she added.
The trials for the drugs will start at the end of the year.
“The Islatravir study, named Impower-022 will start before the end of the year and we are going to recruit 4 500 women from Zimbabwe, Malawi, South Africa, Uganda and USA but Zimbabwe will enrol 150 women who are sexually active and are at risk of HIV infection. The study will take at least three years meaning if we start the research by year-end, we will do it for three years to get the results. We also observe how the research is going because studies can be stopped before three years lapse if we get our desired results or if results are adverse,” she said.
During an HIV Research and Prevention Conference, Islatravir was listed to be the first of a new class of ARVs that will be well tolerated and adequate for HIV prevention that should work for at least a month. Experts added that the same drug, if proved to be effective in HIV prevention when taken once a month, can then be used in similar fashion by HIV-positive people on antiretroviral therapy.
“If these findings are confirmed in larger studies, Islatravir is a new option for long-acting pre-exposure prophylaxis (PrEP) and could be a huge potential game changer,” said International Aids Society president Dr Adeeba Kamarulzman.
Zimbabwe has one of the highest HIV burdens in sub-Saharan Africa at 12,8 percent with about 1,4 million people living with HIV in 2019 and about 730 000 women living with the virus in Zimbabwe in 2018. In the same year, it was reported that 19 000 women became HIV-positive compared to 14 000 men. — @NyembeziMu
